Report on the National Patient Choice Survey - February 2010 England Report on the National Patient Choice Survey - February 2010 England

Prepared by Sheila Dixon, Department of Health June 2010 | **Policy** | Estates | |--------------------|------------------| | HR/Workforce | Performance | | Management | IM & T | | Planning | Finance | | Clinical | Partnership working |

| **Document** | Statistical publication | |--------------------|--------------------------| | **ROCR ref:** | n/a | | **Gateway ref:** | n/a | | **Title:** | Report on the National Patient Choice Survey - February 2010 England | | **Author:** | Sheila Dixon | | **Publication** | June 2010 | | **Target** | Public and NHS | | **Circulation list:** | On-line publication only | | **Description:** | Statistical publication of the results of the National Patient Choice survey for referrals made in February 2010. | | **Cross ref:** | http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Statistics/DH_103479 | | **Superseded docs:** | n/a | | **Action required:** | n/a | | **Timing:** | June 2010 | | **Contact details:** | Sheila.Dixon@dh.gsi.gov.uk |

© Crown copyright 2010 First published June 2010

Published to DH website, in electronic PDF format only. http://www.dh.gov.uk/en/Publicationsandstatistics Contents

Results of the National Patient Choice Survey – February 2010 England........ 7 Introduction ........................................................................................................ 7 Key findings ...................................................................................................... 7 Choice of hospital ............................................................................................ 8 Awareness of choice ........................................................................................ 8 Going to the hospital of choice ....................................................................... 9 Sources of information on choice ................................................................... 9 Factors influencing choice ............................................................................. 10 Booking the first appointment ...................................................................... 11 Waiting for the first appointment .................................................................. 11 Results by type of provider .......................................................................... 11 Variation by SHA ............................................................................................ 12 Variation by PCT ............................................................................................. 13

Annex A: Tables of results of the National Patient Choice Survey - February 2010 England ........................................................................................................ 15 Table A.1 Patients aware of choice, discussing, offered and having information for choice, February 2010 ................................................................. 15 Table A.2 Patients aware of choice, offered choice and able to go to the hospital they wanted, surveys to date ................................................................. 16 Table A.3 Patients going where wanted, booking, offered choice of date and time, satisfied with wait and aware of how to complain, February 2010 .............. 17 Table A.4 Patients offered choice of date and time by how booked, February 2010 ........................................................................................................ 18 Table A.5 Most important source of information when patient chose their hospital, February 2010 .................................................................................. 18 Table A.6 Most important factor for patients offered choice when choosing their hospital, February 2010 ........................................................................ 19 Table A.7 Patient responses by type of provider, February 2010 .................. 20 Table A.8 Patients aware of choice, offered choice and going to the hospital they wanted by PCT, February 2010 ................................................................. 21 Table A.9 Number and percentage of PCTs by percentage of patients offered choice, surveys to date ................................................................. 24 Table A.10 Percentage of patients offered choice by SHA, surveys to date ...... 24 Table A.11 Percentage of patients aware of choice by SHA, surveys to date .... 25

Annex B: Notes on the survey methodology .................................................. 27 Background .................................................................................................... 27 Methodology .................................................................................................. 27 Questionnaire redesign .................................................................................. 28 Response ........................................................................................................ 28 Weighting for non-response ......................................................................... 28 Issues for PCT results .................................................................................... 29

Annex C: Survey questionnaire ...................................................................... 31 Annex D: Combined survey results by age, sex, ethnic group and long-standing illness

Background .................................................................................................................. 33 Age and sex results ....................................................................................................... 33 Ethnic group results ..................................................................................................... 35 Long-standing illness results ....................................................................................... 37 Table D.1 Percentage of patients aware of choice by age, sex, ethnic group and long-standing illness, surveys to date ................................................................. 38 Table D.2 Percentage of patients offered choice by age, sex, ethnic group and long-standing illness, surveys to date ................................................................. 39 Table D.3 Percentage of patients able to go where they wanted by age, sex, ethnic group and long-standing illness, surveys to date .............................................. 40 Results of the National Patient Choice Survey – February 2010 England.

Introduction Most patients(^1) have a right to choose any clinically appropriate provider in England that meets NHS standards and costs on referral for their first outpatient appointment.

The Department of Health commissioned a series of national patient choice surveys to assess the offer and awareness of choice at PCT level. The results were published in a series of reports, the latest was for the survey in March(^2) 2009.

This report gives summary results of around 69,000 responses to a follow-up survey, for referrals made in February 2010. There are no further follow-up surveys planned.

Key findings

- The percentage of patients recalling being offered a choice of hospital for their first outpatient appointment was 49% in February 2010, up from 47% in March 2009 and 30% in the first survey (May/June 2006).
- 54% of patients were aware before they visited their GP that they had a choice of hospitals for their first appointment, up from 50% in March 2009 and 29% in the May/June 2006 survey.
- 63% of patients who were aware of choice recalled being offered choice, whereas only 32% of those not aware of choice recalled being offered it, similar to the March 2009 survey (62% and 32% respectively).
- 67% of patients were able to go to the hospital they wanted, with a further 22% having no preference and 8% unable to go where they wanted, similar to 67%, 23% and 8% respectively in March 2009.
- 88% of patients offered choice were able to go to the hospital they wanted, with a further 5% having no preference. This compares with 47% of patients not

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(^1) Eligible patients are those for whom a choice of providers should be offered for their elective care, although in some cases the number of appropriate choices might be reduced for clinical reasons. Other patients might receive choice but it is not a right. This includes patients for whom the speed of access to diagnosis and treatment is particularly important: emergency attendances, Rapid Access Chest Pain Clinics or patients attending cancer services under the 2 week maximum waiting time and those where other aspects of choice may be more important: maternity services and mental health.

(^2) Report on the National Patient Choice Survey – March 2009 England, DH, August 2009. See the DH website for the full set of published reports at: www.dh.gov.uk/en/Publicationsandstatistics/Statistics/StatisticalWorkAreas/Statisticalhealthcare/DH_086298 offered choice being able to go where they wanted and 40% having no preference.

- 77% of patients were satisfied with how long they had to wait from the time their GP referred them to when they saw the hospital specialist.
- For those who were offered a choice, a hospital close to home or work was selected most often (by 38% of patients offered choice) as the single most important factor when choosing their hospital.

Choice of hospital The percentage of patients who recalled being offered a choice of hospital for their first outpatient appointment was 49% in February 2010. This compares with between 43% and 48% doing so in surveys from January 2007 to March 2009 and 30% in the first (May/June 2006) survey. The percentage of patients aware of choice has risen more consistently over the period, see Figure 1 and Annex Table A.2. In addition, 40% of patients in February 2010 said they discussed which hospital they might go to with their GP. 25% of patients were aware of how to complain if they felt they were not offered a choice of hospital(^1), with 64% unaware (see Annex Table A.3).

Figure 1. Percentage of patients aware of and offered choice and able to go to the hospital they wanted, surveys to date

![Graph showing percentage of patients aware of and offered choice and able to go to the hospital they wanted, surveys to date.](image)

Awareness of choice The percentage of patients who said that they knew before visiting their GP that there is now choice of hospital for a first hospital appointment was 54% in February 2010, up from 50% in March 2009 and 29% in the first (May/June 2006), see Figure 1 and Annex Table A.2.

The 54% of patients who were aware of choice were more likely to say that they were offered a choice of hospital than those who were unaware of choice. 63% of

(^1) For the first time in the series of National Patient Choice Surveys, patients were asked whether they were aware of how to complain if they were not offered a choice of hospital, see Annex B and C. patients who knew about choice recalled being offered it, whereas only 32% of those not knowing about choice recalled being offered it (Annex Table A.1). This difference is similar to previous surveys (eg 62% and 32% respectively in March 2009).

**Going to the hospital of choice**

67% of patients were able to go to the hospital they wanted, with a further 22% having no preference and 8% unable to go where they wanted. This is similar to the March 2009 survey, when 67% of patients went to the hospital they wanted, 23% had no preference and 8% were unable to go where they wanted. For patients offered choice, 88% were able to go where they wanted whilst 6% were not and 5% had no preference. This was different from patients not offered choice, 47% of whom went where they wanted but 40% did not have a preference, see Figure 2 and Annex Table A.3. This may imply that the process of being offered and discussing choice helps patients to decide a preferred hospital.

**Figure 2. Percentage of patients who were able to go to the hospital they wanted, by whether they were offered choice**

![Figure 2](image)

**Sources of information on choice**

The GP was the single most important source of information to help choose their hospital for 43% of patients offered choice. The patient's own experience, or that of their friends and family, was given by 29% as the most important source of information when choosing. A booklet about choice was given by 6% patients, whilst 4% gave the NHS Choices website, see Figure 3 and Annex Table A.4. Although not directly comparable with earlier surveys(^1), the same sources of information were given most often in March 2009. 83% of patients offered choice reported that they had enough information to help them make their choice(^2) (see Annex Table A.1).

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(^1) Patients were asked to select the single most important source of information. This differs from earlier surveys, where patients were invited to select as many sources as applied.

(^2) This question was introduced for the February 2010 survey, see Annex B and C. Factors influencing choice Closeness to work or home was selected most often (by 38% of patients who were offered choice) as the single most important factor(^1) when choosing their hospital, see Figure 4 and Annex Table A.6. Other patients cited personal experience of the hospital and good previous experience (given by 12% and 6% of patients respectively), waiting times (10%), accessibility (5%) and quality of care (5%). Location issues (differently defined), waits and quality of care were also in the top six factors selected most often in previous surveys, where all patients were invited to select as many factors as they felt were most important in choosing a hospital. Whilst earlier surveys identified cleanliness or low levels of infection and friendliness of staff as important factors for patients, these were the single most important factor for only 2% and 1% respectively of patients choosing a hospital in February 2010.

(^1) Patients offered choice were asked to select the single most important factor when they chose their hospital. This is not directly comparable with earlier surveys, where all patients were invited to select as many factors as they felt were most important in choosing a hospital. Booking the first appointment

34% of patients booked their first hospital appointment when the hospital contacted them following a letter from the GP, compared with 35% in the March 2009 survey. Of the others, 27% patients telephoned an appointments line, 22% were booked on screen (by the GP or other practice staff) and 8% used the internet (up from 6% in March 2009). 45% of patients who did not recall being offered choice booked their appointment when the hospital contacted them, whilst only half as many patients (23%) who were offered choice booked this way, see Annex Table A.3.

41% of patients were offered a choice of different dates and times of day when their first appointment was made. More patients who recalled being offered a choice of hospital were also offered a choice of date and time (56%) than those who were not offered a choice of hospital (27% offered a choice of date and time). The choice of date and time varied by the method of booking (see Annex Table A.4). 26% of those who booked when the hospital contacted them were offered a choice of date and time, compared with 41% of those booked on screen in the surgery, 56% of those calling an appointments line and 85% of those booking via the internet.

Waiting for the first appointment

77% of patients were satisfied with how long they had to wait from the time their GP referred them to when they saw the hospital specialist, compared with 76% in March 2009. The level of satisfaction was higher amongst those who were offered choice (81%, with 16% dissatisfied) than amongst those who were not (74%, with 20% dissatisfied), see Annex Table A.3, which may indicate a benefit of offering choice.

Results by type of provider

The proportion of patients who reported being offered choice whose first outpatient appointment was in an Independent Sector (IS) provider was higher than for patients going to NHS organisations: 60% compared with 48%, see Figure 5 and Annex Table A.7. This compares with 60% for those going to IS and 47% for NHS providers in the March 2009 survey. However, only 740 (1%) patients taking part in the survey went to IS providers. The proportion of patients offered a choice of date and time for their first outpatient appointment was also higher in IS providers: 57% compared with 41% for patients going to NHS organisations (not explained by differences in the method of booking). Of those offered a choice of provider, IS hospital patients often gave the length of wait or the location as the single most important factor when choosing, whilst more NHS hospital patients gave the location or their own experience (see Annex Table A.7). As before, the difference between the proportions of patients from IS and NHS providers who were aware of choice before visiting their GP was smaller.

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1 For the first time in the series of National Patient Choice Surveys, patients were asked whether they were offered a choice of date and time when their appointment was booked, see Annex B and C. Variation by SHA

The proportion of patients who recalled being offered a choice of hospital for their first outpatient appointment, 49% nationally, varied by SHA as shown in Figure 6 and Annex Table A.10. Most SHAs showed an increase in the percentage of patients offered choice in February 2010 compared with the March 2009 survey.

The proportion of patients who were aware that they had a choice of hospital for their first outpatient appointment, 54% nationally, varied by SHA as shown in Figure 7 and Annex Table A.11. All SHAs showed an increase in patient awareness of choice compared with the March 2009 survey. Figure 7. Percentage of patients aware of choice, surveys to date, by SHA ranked for February

Note: SHA results are not weighted to adjust for age and sex bias in the responding sample, see Annex B, whereas national estimates are weighted.

Variation by PCT

In 21 out of 145(^1) PCTs (14%), over 60% of patients were offered choice, see Figure 8 and Annex Table A.9, whilst under 40% of patients were offered choice in 27 (19%) PCTs. This compares with 15 PCTs in the March 2009 survey with over 60% of patients offered choice and 32 PCTs with under 40% of patients offered choice. The proportion of patients aware of choice was under 40% in 3 (2%) PCTs, down from 6 (4%) in the March 2009 survey.

Figure 8. Number of PCTs by the proportions of patients offered choice and aware of choice

(^1) Fewer than 20 responses were received for patients from seven of the 152 PCTs, see Annex B. Since results based on so few responses may be misleading, they are omitted from this analysis. The percentage of patients able to go to the hospital they wanted, 67% nationally, varied by PCT as shown in Figure 9 and Annex Table A.8. Most of the remaining patients had no preference (22% nationally), although more than 10% patients said they were not able to go where they wanted in 28 (19%) PCTs. PCTs where fewer patients were able to go where they wanted tended to have lower levels of choice being offered.

Figure 9. Percentage of patients able to go where they wanted and offered choice, by ranked PCT

The geographic variation in the percentage of patients who said they were offered a choice of hospital in February 2010 and in March 2009 is illustrated in the PCT maps in Figure 10, see also Annex Table A.8. However, some PCT figures shown are based on relatively few responses, with the possibility of response bias, so results for individual PCTs should be treated with caution.

Figure 10. PCT Maps of percentage of patients offered choice Annex A: Tables of results of the National Patient Choice Survey - February 2010 England

Table A.1 Patients aware of choice, discussing, offered and having information for choice, February 2010.

| Q1 Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment? | Total(^2) | Yes | No | |---|---|---|---| | Number | Percent | Number | Percent | Number | Percent | | 69,040 | 100% | 36,984 | 54% | 31,523 | 46% |

Q2 Did you discuss which hospital you might go to with your GP?

| | Yes | No | Don't know | Not stated | |---|---|---|---|---| | Number | 27,889 | 39,095 | 1,424 | 632 | | Percent | 40% | 57% | 2% | 1% |

Q3 Were you offered a choice of hospital for your first hospital appointment?

| | Yes | No | Don't know | Not stated | |---|---|---|---|---| | Number | 33,525 | 32,628 | 2,048 | 840 | | Percent | 49% | 47% | 3% | 1% |

For patients offered choice (‘Yes’ to Q3)

Q5 Did you have enough information to help you make your choice?

| | Yes | No | Not stated | |---|---|---|---| | Number | 27,166 | 4,486 | 902 | | Percent | 83% | 14% | 3% |

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1. Apart from Q1, percentages are calculated as a proportion of the total within each column.
2. Total columns include responding patients who did not state whether they knew they had a choice of hospitals before visiting their GP. This accounts for 534 (1%) responses.
3. Total for Q5 excludes 971 (3%) responses for patients sent the previous survey form and offered choice (see Annex B). Table A.2 Patients aware of choice, offered choice and able to go to the hospital they wanted, surveys to date

| Survey | Total | Aware of choice | Offered choice | Able to go where wanted | |-----------------|-------|-----------------|----------------|-------------------------| | | | %Yes | %No | %Yes | %No | %Yes | %No | %No preference | | May/June 2006 | 78,773| 29% | 69% | 30% | 64% | | | | | July 2006 | 70,084| 32% | 67% | 35% | 59% | | | | | September 2006 | 70,580| 32% | 67% | 38% | 57% | | | | | November 2006 | 56,928| 35% | 64% | 41% | 53% | | | | | January 2007 | 73,000| 36% | 63% | 45% | 50% | | | | | March 2007 | 75,290| 37% | 62% | 48% | 47% | | | | | May 2007 | 75,191| 38% | 61% | 44% | 50% | | | | | July 2007 | 62,264| 38% | 61% | 43% | 50% | | | | | September 2007 | 92,545| 39% | 60% | 45% | 49% | | | | | November 2007 | 77,804| 41% | 58% | 44% | 52% | 65% | 7% | 25% | | January 2008 | 72,153| 43% | 57% | 46% | 50% | 67% | 7% | 23% | | March 2008 | 109,331| 43% | 56% | 47% | 48% | 67% | 7% | 23% | | May 2008 | 89,903| 45% | 54% | 45% | 50% | 66% | 8% | 24% | | July 2008 | 93,528| 47% | 53% | 46% | 49% | 66% | 8% | 23% | | September 2008 | 93,003| 48% | 51% | 46% | 50% | 67% | 8% | 23% | | December 2008 | 75,878| 50% | 50% | 46% | 49% | 68% | 7% | 23% | | March 2009 | 93,217| 50% | 49% | 47% | 49% | 67% | 8% | 23% | | February 2010 | 69,040| 54% | 46% | 49% | 47% | 67% | 8% | 22% |

1. Response to Q1 ‘Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment?’
2. Response to Q3 ‘Were you offered a choice of hospital for your first hospital appointment?’
3. Response to Q7 (introduced as Q5 November 2007) ‘Were you able to go to the hospital that you wanted to go to?’
4. Total valid responses, weighted by age and sex (see Annex B); includes patients who replied ‘don’t know’ or did not respond to the question. Table A.3 Patients going where wanted, booking, offered choice of date and time, satisfied with wait and aware of how to complain, February 2010.

| Q3 Were you offered a choice of hospital for your first hospital appointment? | Total | Yes | No | |---|---|---|---| | Number | Percent | Number | Percent | Number | Percent | | 69,040 | 100% | 33,525 | 49% | 32,628 | 47% |

Q7 Were you able to go to the hospital that you wanted to go to?

| | Yes | No | I didn't have a preference | Not stated | |---|---|---|---|---| | Number | 46,366 | 5,280 | 15,277 | 2,117 | | Percent | 67% | 8% | 22% | 3% |

Q8 How did you book your first hospital appointment?

| | GP wrote and hospital contacted me | Telephoned a call centre | On screen (with GP or practice staff) | Via internet | All other responses | |---|---|---|---|---|---| | Number | 23,432 | 18,567 | 15,398 | 5,365 | 6,277 | | Percent | 34% | 27% | 22% | 8% | 9% |

Q9 When your first hospital appointment was made, were you offered a choice of different dates and times of day?

| | Yes | No | Don't know / not stated | |---|---|---|---| | Number | 27,734 | 35,299 | 4,130 | | Percent | 41% | 53% | 6% |

Q10 How satisfied or dissatisfied were you with how long you had to wait from the time your GP referred you to a hospital to when you actually saw the hospital?

| | Very satisfied | Fairly satisfied | Not very satisfied | Not at all satisfied | No appointment date yet | Don't know / not stated | |---|---|---|---|---|---|---| | Number | 28,383 | 24,744 | 7,708 | 4,790 | 1,506 | 1,907 | | Percent | 41% | 36% | 11% | 7% | 2% | 3% |

Q11 Are you aware of how to complain if you feel you were not offered a choice of hospital?

| | Yes | No | Don't know / not stated | |---|---|---|---| | Number | 16,999 | 43,057 | 7,108 | | Percent | 25% | 64% | 11% |

1. Apart from Q3, percentages are calculated as a proportion of the total within each column.
2. Total columns include responding patients who did not know or did not state whether they were offered a choice of hospital. This accounts for 2,888 (4%) responses.
3. Figures for Q9 and Q11 exclude 1,876 (3%) responses for patients sent the previous survey form (see Annex B). Table A.4 Patients offered choice of date and time by how booked, February 2010.

| Q8 How did you book your first hospital appointment? | Total(^2) | Yes | No | |-----------------------------------------------------|-------------|-----|----| | GP wrote and hospital contacted me | 22,791 | 5,938 | 15,790 | | Telephoned a call centre | 18,149 | 10,116 | 7,290 | | On screen (with GP or practice staff) | 14,906 | 6,097 | 7,983 | | Via internet | 5,206 | 4,429 | 700 | | All other responses | 6,112 | 1,156 | 3,535 | | Total | 67,164 | 27,734 | 35,299 |

1. Percentages are calculated as a proportion of the total within each row.
2. Total column includes 4,130 (6%) responding patients who did not know or did not state whether they were offered a choice of different dates and times of day and excludes 1,876 (3%) responses for patients sent the previous survey form (see Annex B).

Table A.5 Most important source of information when patient chose their hospital, February 2010.

| Sources listed(^1) | No. patients | Percent of responses | |----------------------|--------------|---------------------| | My GP | 13,960 | 43% | | Friends / family members / own experience | 9,556 | 29% | | A booklet or leaflet about my choices | 1,892 | 6% | | NHS Choices website | 1,407 | 4% | | Staff at Clinical Assessment or Referral Centre | 956 | 3% | | Someone else at GP surgery | 490 | 2% | | Local patient organisation | 192 | 1% | | Other internet site | 165 | 1% | | Don't know | 2,531 | 8% | | Not stated | 1,406 | 4% | | Total(^2) | 32,554 | 100% |

1. Patients who said they had been offered choice were invited to select, from a list of sources, the one most important to them when choosing their hospital. This differs from earlier surveys, where such patients were invited to select as many sources as applied.
2. Total excludes 970 (3%) responses for patients sent the previous survey form (see Annex B). Table A.6 Most important factor for patients offered choice when choosing their hospital, February 2010.

| Most important factors listed | No. patients | Percent of responses | |------------------------------|--------------|----------------------| | Close to your home or work | 12,410 | 38% | | Personal experience of the hospital | 3,874 | 12% | | Length of wait for appointment | 3,120 | 10% | | Good previous experience | 1,835 | 6% | | Accessible on public transport / Travel costs | 1,696 | 5% | | Quality of care | 1,594 | 5% | | Reputation of hospital | 1,390 | 4% | | GP / assessment centre doctor recommendation | 1,257 | 4% | | Experience of friends or family members | 924 | 3% | | Availability of car parking | 812 | 2% | | Ability to see consultant of your choice | 775 | 2% | | Convenience of appointment time | 712 | 2% | | Cleanliness / rates of infection | 671 | 2% | | Friendliness of staff | 344 | 1% | | Cost of car parking | 209 | 1% | | Standard of facilities | 143 | 0% | | Quality of food | 24 | 0% | | Don't know | 358 | 1% | | Not stated | 407 | 1% | | Total | 32,554 | 100% |

1. Patients who said they had been offered choice were asked to select the single most important factor when they chose their hospital. This is not directly comparable with earlier surveys, where all patients were invited to select as many factors as they felt were most important in choosing a hospital.

2. Total excludes 970 (3%) responses for patients sent the previous survey form (see Annex B).

### Table A.7 Patient responses by type of provider, February 2010

#### Numbers and percentages

| Type of provider of outpatient service | Total¹ | Independent Sector² | NHS | |---------------------------------------|--------|----------------------|-----| | | Number | Percent | Number | Percent | Number | Percent | | Q1 Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment? | | | | | | | | Yes | 36,984 | 54% | 355 | 48% | 36,628 | 54% | | No | 31,523 | 46% | 376 | 51% | 31,146 | 46% | | Not stated | 534 | 1% | 2 | 0% | 531 | 1% | | Total | 69,040 | 100% | 734 | 100% | 68,306 | 100% |

| Q3 Were you offered a choice of hospital for your first hospital appointment? | | | | | | | | Yes | 33,525 | 49% | 442 | 60% | 33,083 | 48% | | No | 32,628 | 47% | 276 | 38% | 32,351 | 47% | | Don't know | 2,048 | 3% | 11 | 2% | 2,037 | 3% | | Not stated | 840 | 1% | 5 | 1% | 835 | 1% | | Total | 69,040 | 100% | 734 | 100% | 68,306 | 100% |

For patients offered choice ('Yes' to Q3)

| Q6 Which was the single most important thing for you when you chose your hospital? | | | | | | | | Close to home or work | 12,410 | 38% | 85 | 22% | 12,325 | 38% | | Personal experience | 3,874 | 12% | 25 | 6% | 3,850 | 12% | | Length of wait | 3,120 | 10% | 85 | 22% | 3,035 | 9% | | Good previous experience | 1,835 | 6% | 17 | 4% | 1,818 | 6% | | Accessibility | 1,696 | 5% | 8 | 2% | 1,688 | 5% | | Quality of care | 1,594 | 5% | 21 | 5% | 1,573 | 5% | | All other responses | 8,025 | 25% | 151 | 39% | 7,874 | 24% | | Total | 32,554 | 100% | 391 | 100% | 32,163 | 100% |

| Q7 Were you able to go to the hospital that you wanted to go to? | | | | | | | | Yes | 46,366 | 67% | 489 | 67% | 45,877 | 67% | | No | 5,280 | 8% | 46 | 6% | 5,234 | 8% | | I didn't have a preference | 15,277 | 22% | 184 | 25% | 15,093 | 22% | | Not stated | 2,117 | 3% | 15 | 2% | 2,102 | 3% | | Total | 69,040 | 100% | 734 | 100% | 68,306 | 100% |

| Q9 When your first hospital appointment was made, were you offered a choice of different dates and times of day? | | | | | | | | Yes | 27,734 | 41% | 367 | 57% | 27,367 | 41% | | No | 35,299 | 53% | 250 | 39% | 35,049 | 53% | | Don't know / not stated | 4,130 | 6% | 28 | 4% | 4,103 | 6% | | Total | 67,164 | 100% | 645 | 100% | 66,519 | 100% |

| Q10 How satisfied or dissatisfied were you with how long you had to wait from the time your GP referred you to a hospital to when you actually saw the hospital? | | | | | | | | Very satisfied | 28,383 | 41% | 427 | 58% | 27,956 | 41% | | Fairly satisfied | 24,744 | 36% | 227 | 31% | 24,517 | 36% | | Not very satisfied | 7,708 | 11% | 41 | 6% | 7,668 | 11% | | Not at all satisfied | 4,790 | 7% | 22 | 3% | 4,769 | 7% | | No appointment date yet | 1,506 | 2% | 2 | 0% | 1,504 | 2% | | Don't know / not stated | 1,907 | 3% | 15 | 2% | 1,892 | 3% | | Total | 69,040 | 100% | 734 | 100% | 68,306 | 100% |

1. Responses may not sum to total due to rounding following age and sex weighting of the survey results.
2. Some Independent Sector providers have taken part in the survey, issuing survey forms to their patients, since the November 2006 survey, see Annex B.
3. Total Q9 excludes 1,876 (3%) responses for patients sent the previous survey form; total Q6 excludes 971 of these who were offered choice (see Annex B).

## Table A.8 Patients aware of choice, offered choice and going to the hospital they wanted by PCT, February 2010

| PCT^4 | SHA^5 | Total^6 | Aware of choice^7 | Offered choice^8 | Able to go where wanted to go^9 | Percentages | |-------|-------|---------|-------------------|------------------|---------------------------------|-------------| | | | | %Yes | %No | %Yes | %No | %Yes | %No | %No preference | | England | | | 69,040 | 54% | 46% | 49% | 47% | 67% | 8% | 22% | | Ashton, Leigh and Wigan | NW | 374 | 61% | 39% | 56% | 40% | 68% | 8% | 20% | | Barking and Dagenham | Lon | 178 | 60% | 40% | 62% | 34% | 63% | 12% | 21% | | Barnet | Lon | 166 | 60% | 40% | 56% | 39% | 73% | 9% | 15% | | Barnsley | YH | 612 | 73% | 26% | 51% | 45% | 74% | 5% | 19% | | Bassetlaw | EM | 354 | 67% | 32% | 53% | 44% | 73% | 6% | 19% | | Bath and North East Somerset | SW | 37 | 62% | 35% | 70% | 22% | 70% | 8% | 16% | | Bedfordshire | EoE | 641 | 58% | 41% | 48% | 49% | 72% | 5% | 20% | | Berkshire East | SC | 58 | 50% | 50% | 50% | 47% | 71% | 12% | 17% | | Berkshire West | SC | 97 | 57% | 43% | 67% | 28% | 76% | 10% | 11% | | Bexley Care Trust | Lon | 60 | 53% | 47% | 55% | 45% | 72% | 7% | 20% | | Birmingham East and North | WM | 43 | 58% | 40% | 63% | 35% | 70% | 5% | 21% | | Blackburn with Darwen | NW | 235 | 65% | 35% | 64% | 31% | 73% | 11% | 14% | | Teaching | | | | | | | | | | | | Blackpool | NW | 301 | 60% | 40% | 50% | 47% | 73% | 6% | 17% | | Bolton | NW | 400 | 62% | 38% | 59% | 37% | 77% | 7% | 14% | | Bournemouth and Poole | SW | 1,077 | 54% | 45% | 46% | 51% | 71% | 6% | 20% | | Teaching | | | | | | | | | | | | Bradford and Airedale Teaching | YH | 539 | 57% | 43% | 45% | 50% | 61% | 10% | 26% | | Brent Teaching | Lon | 193 | 50% | 49% | 46% | 46% | 65% | 8% | 24% | | Brighton and Hove City | SEC | 525 | 44% | 56% | 39% | 55% | 60% | 8% | 28% | | Bristol | SW | 296 | 46% | 53% | 48% | 46% | 67% | 6% | 25% | | Bromley | Lon | 52 | 48% | 48% | 31% | 62% | 48% | 12% | 31% | | Buckinghamshire | SC | 850 | 47% | 50% | 43% | 51% | 63% | 9% | 22% | | Bury | NW | 243 | 62% | 38% | 54% | 42% | 72% | 8% | 19% | | Calderdale | YH | 381 | 61% | 38% | 55% | 41% | 72% | 5% | 21% | | Cambridgeshire | EoE | 363 | 57% | 42% | 52% | 42% | 72% | 5% | 20% | | Camden | Lon | 75 | 65% | 35% | 57% | 33% | 80% | 5% | 13% | | Central & Eastern Cheshire | NW | 867 | 62% | 36% | 54% | 42% | 73% | 6% | 17% | | Central Lancashire | NW | 331 | 66% | 34% | 64% | 33% | 77% | 7% | 14% | | City and Hackney Teaching | Lon | 165 | 47% | 50% | 39% | 51% | 65% | 7% | 23% | | Cornwall and Isles of Scilly | SW | 437 | 49% | 51% | 41% | 55% | 54% | 13% | 25% | | County Durham | NE | 1,074 | 71% | 29% | 67% | 30% | 77% | 7% | 14% | | Coventry Teaching | WM | 573 | 68% | 31% | 54% | 42% | 76% | 6% | 15% | | Croydon | Lon | 63 | 71% | 29% | 73% | 25% | 71% | 13% | 13% | | Cumbria Teaching | NW | 1,162 | 63% | 36% | 50% | 46% | 74% | 6% | 17% | | Darlington | NE | 166 | 71% | 27% | 52% | 44% | 75% | 10% | 13% | | Derby City | EM | 463 | 49% | 51% | 37% | 60% | 66% | 5% | 27% | | Derbyshire County | EM | 1,031 | 65% | 34% | 58% | 38% | 77% | 4% | 17% | | Devon | SW | 1,222 | 60% | 39% | 49% | 47% | 71% | 6% | 20% | | Doncaster | YH | 337 | 66% | 33% | 47% | 50% | 75% | 5% | 17% | | Dorset | SW | 1,375 | 62% | 37% | 56% | 39% | 74% | 7% | 16% | | Dudley | WM | 149 | 56% | 43% | 38% | 62% | 63% | 9% | 27% | | Ealing | Lon | 364 | 56% | 44% | 45% | 51% | 69% | 8% | 21% | | East and North Hertfordshire | EoE | 82 | 68% | 30% | 54% | 44% | 66% | 12% | 18% | | East Lancashire Teaching | NW | 657 | 72% | 28% | 71% | 25% | 73% | 10% | 15% | | East Riding of Yorkshire | YH | 753 | 49% | 50% | 42% | 55% | 58% | 11% | 27% | | East Sussex Downs and Weald | SEC | 875 | 54% | 45% | 39% | 56% | 65% | 6% | 26% | | Eastern and Coastal Kent | SEC | 1,041 | 57% | 42% | 52% | 45% | 68% | 9% | 19% | | Enfield | Lon | 222 | 55% | 44% | 43% | 50% | 66% | 9% | 20% | | Gateshead | NE | 409 | 71% | 29% | 59% | 37% | 72% | 6% | 20% | | Gloucestershire | SW | 1,115 | 56% | 44% | 56% | 41% | 73% | 7% | 17% | | Great Yarmouth and Waveney | EoE | 100 | 64% | 35% | 52% | 43% | 71% | 2% | 23% | | Greenwich Teaching | Lon | 331 | 53% | 46% | 46% | 48% | 68% | 7% | 22% | | Halton and St Helens | NW | 669 | 62% | 38% | 60% | 37% | 71% | 10% | 16% | | PCT | SHA | Total | %Yes | %No | %Yes | %No | %Yes | %No | %No preference | |-----|-----|-------|------|-----|------|-----|------|-----|----------------| | Hammersmith and Fulham | Lon | 2 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | | Hampshire | SC | 2,446 | 52% | 47% | 45% | 51% | 67% | 7% | 23% | | Haringey Teaching | Lon | 268 | 61% | 39% | 51% | 43% | 71% | 7% | 20% | | Harrow | Lon | 176 | 55% | 44% | 55% | 41% | 68% | 6% | 21% | | Hartlepool | NE | 40 | 65% | 35% | 58% | 38% | 70% | 5% | 20% | | Hastings and Rother | SEC | 548 | 51% | 49% | 35% | 61% | 69% | 6% | 22% | | Havering | Lon | 271 | 59% | 41% | 76% | 22% | 77% | 6% | 14% | | Heart of Birmingham Teaching | WM | 31 | 29% | 71% | 29% | 55% | 71% | 6% | 23% | | Herefordshire | WM | 548 | 49% | 51% | 32% | 65% | 66% | 4% | 25% | | Heywood, Middleton and Rochdale | NW | 273 | 64% | 34% | 54% | 41% | 70% | 9% | 20% | | Hillingdon | Lon | 616 | 42% | 57% | 29% | 67% | 56% | 14% | 27% | | Hounslow | Lon | 56 | 41% | 54% | 59% | 34% | 64% | 9% | 25% | | Hull Teaching | YH | 555 | 50% | 49% | 41% | 55% | 54% | 9% | 34% | | Isle of Wight NHS | SC | 387 | 45% | 55% | 18% | 77% | 57% | 5% | 33% | | Islington | Lon | 133 | 64% | 35% | 56% | 32% | 74% | 9% | 16% | | Kensington and Chelsea | Lon | 25 | 44% | 52% | 56% | 36% | 76% | 8% | 12% | | Kingston | Lon | 46 | 61% | 39% | 57% | 39% | 61% | 17% | 11% | | Kirklees | YH | 717 | 54% | 45% | 52% | 43% | 70% | 8% | 19% | | Knowsley | NW | 358 | 50% | 50% | 49% | 47% | 66% | 10% | 22% | | Lambeth | Lon | 378 | 53% | 46% | 49% | 46% | 75% | 6% | 17% | | Leeds | YH | 1,578 | 50% | 49% | 39% | 57% | 55% | 11% | 30% | | Leicester City | EM | 497 | 39% | 61% | 33% | 61% | 50% | 11% | 35% | | Leicestershire County and Rutland | EM | 829 | 49% | 51% | 44% | 54% | 57% | 11% | 28% | | Lewisham | Lon | 482 | 52% | 46% | 44% | 51% | 63% | 6% | 27% | | Lincolnshire Teaching | EM | 740 | 62% | 38% | 55% | 42% | 64% | 13% | 22% | | Liverpool | NW | 1,098 | 54% | 44% | 52% | 44% | 69% | 8% | 21% | | Luton | EoE | 166 | 51% | 47% | 34% | 61% | 63% | 7% | 25% | | Manchester | NW | 749 | 47% | 52% | 36% | 59% | 61% | 9% | 26% | | Medway | SEC | 109 | 60% | 40% | 63% | 33% | 71% | 10% | 17% | | Mid Essex | EoE | 593 | 46% | 54% | 34% | 63% | 59% | 8% | 31% | | Middlesbrough | NE | 4 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | | Milton Keynes | SC | 518 | 51% | 48% | 36% | 59% | 63% | 6% | 28% | | Newcastle | NE | 31 | 58% | 42% | 68% | 26% | 52% | 23% | 19% | | Newham | Lon | 196 | 48% | 51% | 40% | 53% | 62% | 11% | 24% | | Norfolk | EoE | 841 | 57% | 42% | 59% | 39% | 82% | 7% | 9% | | North East Essex | EoE | 620 | 47% | 52% | 45% | 52% | 61% | 10% | 25% | | North East Lincolnshire Care Trust Plus | YH | 204 | 49% | 50% | 38% | 59% | 59% | 5% | 31% | | North Lancashire Teaching | NW | 805 | 66% | 33% | 64% | 33% | 75% | 7% | 14% | | North Lincolnshire | YH | 306 | 69% | 30% | 59% | 36% | 77% | 3% | 18% | | North Somerset | SW | 302 | 54% | 44% | 53% | 41% | 74% | 8% | 17% | | North Staffordshire | WM | 465 | 67% | 33% | 62% | 35% | 77% | 5% | 15% | | North Tyneside | NE | 239 | 61% | 38% | 48% | 49% | 70% | 7% | 21% | | North Yorkshire and York | YH | 1,160 | 54% | 45% | 42% | 54% | 72% | 5% | 21% | | Northamptonshire Teaching | EM | 657 | 63% | 37% | 60% | 39% | 78% | 5% | 14% | | Northumberland Care Trust | NE | 366 | 61% | 37% | 52% | 44% | 68% | 7% | 22% | | Nottingham City | EM | 374 | 56% | 43% | 44% | 51% | 68% | 8% | 20% | | Nottinghamshire County Teaching | EM | 1,236 | 64% | 36% | 54% | 43% | 75% | 5% | 18% | | Oldham | NW | 300 | 71% | 29% | 72% | 24% | 80% | 8% | 11% | | Oxfordshire | SC | 719 | 55% | 44% | 43% | 53% | 71% | 5% | 20% | | Peterborough | EoE | 287 | 49% | 51% | 37% | 59% | 57% | 6% | 34% | | Plymouth Teaching | SW | 379 | 57% | 42% | 50% | 47% | 75% | 5% | 18% | | Portsmouth City Teaching | SC | 470 | 50% | 49% | 38% | 59% | 56% | 9% | 32% | | Redbridge | Lon | 120 | 58% | 41% | 55% | 39% | 64% | 10% | 22% | | Redcar and Cleveland | NE | 5 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | | Richmond and Twickenham | Lon | 19 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | | Rotherham | YH | 547 | 76% | 24% | 54% | 43% | 78% | 5% | 15% | | PCT | SHA | Total | Aware of choice | Offered choice | Able to go where wanted to go | |-----|-----|-------|-----------------|----------------|-------------------------------| | | | | %Yes | %No | %Yes | %No | %Yes | %No | %No preference | | Salford | NW | 345 | 62% | 37% | 47% | 47% | 72% | 7% | 17% | | Sandwell | WM | 43 | 60% | 37% | 56% | 37% | 63% | 14% | 21% | | Sefton | NW | 261 | 49% | 51% | 44% | 52% | 57% | 10% | 29% | | Sheffield | YH | 1,065 | 54% | 45% | 33% | 63% | 59% | 8% | 30% | | Shropshire County | WM | 65 | 71% | 28% | 68% | 31% | 75% | 6% | 14% | | Solihull Care Trust | WM | 11 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | | Somerset | SW | 555 | 67% | 32% | 62% | 34% | 77% | 6% | 14% | | South Birmingham | WM | 201 | 41% | 59% | 26% | 69% | 62% | 5% | 27% | | South East Essex | EoE | 292 | 66% | 33% | 47% | 48% | 73% | 6% | 20% | | South Gloucestershire | SW | 68 | 60% | 35% | 47% | 40% | 74% | 7% | 13% | | South Staffordshire | WM | 857 | 66% | 34% | 53% | 44% | 70% | 8% | 18% | | South Tyneside | NE | 397 | 65% | 34% | 47% | 48% | 69% | 5% | 23% | | South West Essex | EoE | 604 | 58% | 41% | 56% | 41% | 69% | 10% | 19% | | Southampton City | SC | 296 | 29% | 69% | 24% | 72% | 53% | 4% | 38% | | Southwark | Lon | 388 | 46% | 54% | 42% | 54% | 66% | 5% | 26% | | Stockport | NW | 489 | 58% | 42% | 57% | 38% | 74% | 8% | 15% | | Stockton-on-Tees Teaching | NE | 19 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | | Stoke-on-Trent | WM | 520 | 61% | 38% | 60% | 36% | 76% | 4% | 17% | | Suffolk | EoE | 693 | 45% | 54% | 29% | 67% | 66% | 5% | 26% | | Sunderland Teaching | NE | 584 | 72% | 28% | 52% | 43% | 71% | 6% | 20% | | Surrey | SEC | 1,133 | 53% | 46% | 47% | 48% | 67% | 9% | 21% | | Sutton and Merton | Lon | 529 | 50% | 49% | 48% | 49% | 62% | 10% | 25% | | Swindon | SW | 383 | 52% | 47% | 42% | 52% | 67% | 5% | 25% | | Tameside and Glossop | NW | 458 | 66% | 34% | 53% | 43% | 67% | 6% | 24% | | Telford and Wrekin | WM | 15 | n/a | n/a | n/a | n/a | n/a | n/a | n/a | | Torbay Care Trust | SW | 436 | 56% | 43% | 47% | 51% | 67% | 5% | 19% | | Tower Hamlets | Lon | 51 | 53% | 45% | 59% | 35% | 67% | 16% | 14% | | Trafford | NW | 397 | 55% | 45% | 44% | 52% | 69% | 9% | 21% | | Wakefield District | YH | 586 | 62% | 38% | 59% | 37% | 67% | 12% | 19% | | Walsall Teaching | WM | 198 | 61% | 39% | 50% | 47% | 73% | 2% | 22% | | Waltham Forest | Lon | 39 | 54% | 46% | 72% | 28% | 69% | 10% | 15% | | Wandsworth | Lon | 79 | 49% | 47% | 61% | 32% | 77% | 5% | 15% | | Warrington | NW | 362 | 56% | 44% | 41% | 54% | 67% | 7% | 21% | | Warwickshire | WM | 813 | 61% | 39% | 58% | 39% | 75% | 8% | 15% | | West Essex | EoE | 105 | 61% | 38% | 42% | 54% | 62% | 10% | 22% | | West Hertfordshire | EoE | 564 | 48% | 51% | 50% | 47% | 67% | 8% | 21% | | West Kent | SEC | 1,038 | 51% | 48% | 45% | 51% | 69% | 7% | 21% | | West Sussex | SEC | 332 | 49% | 50% | 40% | 55% | 65% | 13% | 18% | | Western Cheshire | NW | 122 | 57% | 42% | 62% | 36% | 65% | 8% | 20% | | Westminster | Lon | 121 | 52% | 48% | 50% | 41% | 69% | 6% | 23% | | Wiltshire | SW | 684 | 61% | 39% | 49% | 46% | 79% | 3% | 15% | | Wirral | NW | 549 | 60% | 39% | 50% | 47% | 70% | 6% | 21% | | Wolverhampton City | WM | 468 | 54% | 46% | 38% | 57% | 69% | 5% | 22% | | Worcestershire | WM | 747 | 54% | 45% | 40% | 55% | 61% | 10% | 25% |

1. Response to Q1 ‘Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment?’
2. Response to Q3 ‘Were you offered a choice of hospital for your first hospital appointment?’
3. Response to Q7 ‘Were you able to go to the hospital that you wanted to go to?’
4. Responsible Care Trusts and Primary Care Trusts, see Annex B. PCT results are not weighted for any age or sex bias among respondents.
5. Strategic Health Authority based on responsible PCT: NE (North East), NW (North West), YH (Yorkshire & the Humber), EM (East Midlands), WM (West Midlands), EoE (East of England), Lon (London), SEC (South East Coast), SC (South Central) and SW (South West).
6. Total valid responses, including patients who replied ‘don’t know’ or did not respond to the question. The national total is weighted and includes 1,010 (1.5%) cases not listed by responsible PCT because the PCT was not clear. Results for PCTs with fewer than 20 responses have been omitted, whilst those with fewer than 100 responses should be treated with some caution (see Annex B Issues for PCT results).

### Table A.9 Number and percentage of PCTs by percentage of patients offered choice, surveys to date.

| Percentage of patients offered a choice of hospital | May/June 2006 | March 2008 | May 2008 | July 2008 | September 2008 | December 2008 | March 2009 | February 2010 | |---------------------------------------------------|---------------|------------|----------|-----------|----------------|---------------|------------|--------------| | 60% and over | 14 (5%) | 11 (7%) | 7 (5%) | 14 (9%) | 13 (9%) | 16 (11%) | 15 (10%) | 21 (14%) | | 50% to \<60% | 17 (6%) | 49 (32%) | 50 (33%) | 50 (33%) | 52 (34%) | 48 (32%) | 50 (33%) | 55 (38%) | | 40% to \<50% | 34 (11%) | 61 (40%) | 58 (38%) | 52 (34%) | 51 (34%) | 53 (35%) | 55 (36%) | 42 (29%) | | 30% to \<40% | 71 (23%) | 28 (18%) | 31 (20%) | 28 (18%) | 29 (19%) | 26 (17%) | 27 (18%) | 21 (14%) | | 20% to \<30% | 104 (34%) | 3 (2%) | 6 (4%) | 8 (5%) | 7 (5%) | 7 (5%) | 4 (3%) | 5 (3%) | | 10% to < 20% | 59 (19%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 2 (1%) | 1 (1%) | 1 (1%) | | \<10% | 4 (1%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | 0 (0%) | | Total | 303 (100%) | 152 (100%) | 152 (100%) | 152 (100%) | 152 (100%) | 152 (100%) | 145 (100%) | 145 (100%) |

1. For results of the July 2006 to January 2008 surveys, see previous reports.
2. Prior to PCT reconfiguration on 1 October 2006, there were 303 organisations (Care Trusts and Primary Care Trusts), compared with 152 subsequently.
3. In February 2010, seven of the 152 PCTs had fewer than 20 responses and were omitted from this analysis, see Annex B.
4. Percentage of patients who said Yes to: ‘Were you offered a choice of hospital for your first hospital appointment?’

### Table A.10 Percentage of patients offered choice by SHA, surveys to date

| SHA | May/June 2006 | March 2008 | May 2008 | July 2008 | September 2008 | December 2008 | March 2009 | February 2010 | |----------------------|---------------|------------|----------|-----------|----------------|---------------|------------|--------------| | | Total %Yes | Total %Yes | Total %Yes | Total %Yes | Total %Yes | Total %Yes | Total %Yes | Total %Yes | | England | 78,773 30% | 109,331 47% | 89,903 45% | 93,528 46% | 93,003 46% | 75,878 46% | 93,217 47% | 69,040 49% | | North East | 4,238 28% | 6,824 51% | 5,587 47% | 3,922 52% | 5,577 50% | 4,958 50% | 5,235 50% | 3,334 57% | | North West | 11,252 39% | 14,117 52% | 12,751 51% | 13,139 52% | 13,084 52% | 10,447 51% | 13,002 52% | 11,805 54% | | Yorks & Humber | 9,321 26% | 12,486 44% | 9,831 41% | 10,699 41% | 12,165 43% | 9,083 42% | 12,253 44% | 9,340 45% | | East Midlands | 7,240 38% | 10,269 56% | 8,514 52% | 9,701 52% | 10,113 52% | 8,489 51% | 8,937 50% | 6,181 50% | | West Midlands | 7,355 30% | 8,605 45% | 8,208 43% | 8,002 43% | 7,119 44% | 4,840 46% | 6,964 47% | 5,747 49% | | East of England | 8,580 24% | 11,563 45% | 8,976 37% | 8,295 39% | 8,764 40% | 7,252 42% | 8,959 43% | 5,951 46% | | London | 9,350 30% | 11,563 45% | 10,433 45% | 10,318 45% | 8,634 43% | 7,224 45% | 9,180 46% | 5,864 48% | | South East Coast | 7,490 20% | 8,642 44% | 7,530 44% | 6,880 43% | 7,797 44% | 5,950 44% | 7,712 45% | 5,601 44% | | South Central | 5,204 34% | 6,486 47% | 6,051 44% | 7,001 46% | 6,150 45% | 5,756 42% | 7,326 41% | 5,841 41% | | South West | 8,747 27% | 10,690 49% | 8,455 48% | 11,177 50% | 8,274 49% | 8,397 49% | 10,690 49% | 8,366 51% |

1. For results of the July 2006 to January 2008 surveys, see previous reports.
2. Total valid responses. From November 2006, total includes cases not identifiable by SHA (see Annex B).
3. Percentage of patients who said Yes to: ‘Were you offered a choice of hospital for your first hospital appointment?’
4. SHA results are not weighted for any age or sex bias among respondents.

### Table A.11 Percentage of patients aware of choice by SHA, surveys to date

| SHA Region | May/June 2006 | March 2008 | May 2008 | July 2008 | September 2008 | December 2008 | March 2009 | February 2010 | |---------------------|---------------|------------|----------|-----------|----------------|----------------|------------|---------------| | | Total | %Yes | Total | %Yes | Total | %Yes | Total | %Yes | | England | 78,773 | 29% | 109,331 | 43% | 93,528 | 47% | 93,003 | 48% | 75,878 | 50% | 93,217 | 50% | 69,040 | 54% | | North East | 4,238 | 30% | 6,824 | 47% | 5,587 | 49% | 3,922 | 55% | 5,577 | 58% | 4,958 | 63% | 5,235 | 62% | 3,334 | 68% | | North West | 11,252 | 34% | 14,117 | 47% | 12,751 | 50% | 13,139 | 53% | 13,084 | 54% | 10,447 | 56% | 13,002 | 57% | 11,805 | 60% | | Yorks & Humber | 9,321 | 30% | 12,486 | 45% | 9,831 | 46% | 10,699 | 49% | 12,165 | 51% | 9,083 | 51% | 12,253 | 54% | 9,340 | 57% | | East Midlands | 7,240 | 36% | 10,269 | 51% | 8,514 | 53% | 9,701 | 53% | 10,113 | 56% | 8,489 | 57% | 8,937 | 56% | 6,181 | 58% | | West Midlands | 7,355 | 31% | 8,605 | 47% | 8,208 | 48% | 8,002 | 51% | 7,119 | 52% | 4,840 | 54% | 6,964 | 55% | 5,747 | 59% | | East of England | 8,580 | 31% | 11,442 | 43% | 8,976 | 43% | 8,295 | 45% | 8,764 | 47% | 7,252 | 48% | 8,959 | 49% | 5,951 | 53% | | London | 9,350 | 32% | 11,563 | 43% | 10,433 | 46% | 10,318 | 46% | 8,634 | 46% | 7,224 | 48% | 9,180 | 49% | 5,864 | 53% | | South East Coast | 7,490 | 28% | 8,642 | 41% | 7,530 | 43% | 6,880 | 45% | 7,797 | 46% | 5,950 | 48% | 7,712 | 47% | 5,601 | 52% | | South Central | 5,204 | 32% | 6,486 | 43% | 6,051 | 46% | 7,001 | 48% | 6,150 | 48% | 5,756 | 49% | 7,326 | 48% | 5,841 | 50% | | South West | 8,747 | 31% | 10,690 | 47% | 8,455 | 50% | 11,177 | 49% | 8,274 | 51% | 8,397 | 53% | 10,690 | 53% | 8,366 | 58% |

1. For results of the July 2006 to January 2008 surveys, see previous reports.
2. Total valid responses. From November 2006, total includes cases not identifiable by SHA (see Annex B).
3. Percentage of patients who said Yes to: ‘Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment?’
4. SHA results are not weighted for any age or sex bias among respondents. Annex B: Notes on the survey methodology

Background This is the eighteenth National Patient Choice Survey conducted by Ipsos MORI on behalf of the Department of Health, as a follow-up to the series of surveys used to monitor patient awareness of choice and recall of having been offered a choice of hospital for their first outpatient appointment. The surveys provide a national overview of choice and summary results at PCT level. National surveys were conducted for referrals in May/June, July, September and November 2006, January, March, May, July, September and November 2007, January, March, May, July, September and December 2008, March 2009 and now February 2010.

Methodology The methodology of the February 2010 survey was similar to the previous series of surveys. Patients who had been referred by a GP for a first outpatient appointment in any of 123 major acute NHS trusts or 12 Independent Sector (IS) organisations during the two-week period 15 to 28 February 2010 were invited to take part in the survey. Patients aged under 16 or referred for specialties exempted from choice were omitted from the survey (including urgent referrals, two week wait cancer patients, antenatal patients and those referred to rapid access chest pain clinics or mental health specialties – see footnote on Page 7).

These providers of care together account for three quarters of NHS GP referrals to first outpatient appointments. This is a lower share than for previous surveys, because more providers did not take part in the survey, but still gives a reasonable sample in most areas (see ‘Issues for PCT results’ below). Although the Independent Sector units receive relatively few referrals, their inclusion in the survey (from November 2006) helps to ensure representation of these patients, who might have a different experience of choice.

The providers were asked to issue the survey questionnaire within a week of the two-week period. Around 205,000 questionnaires were issued. Patients were invited to complete the questionnaire and return it using the pre-paid Ipsos MORI reply envelope. The questionnaires were anonymous except for the information pre-completed regarding the issuing Trust and the responsible PCT of the patient (see below for issues regarding the PCT information). All responses were treated as completely confidential. Questionnaire redesign Following a review of the questionnaire design, changes were implemented for the February 2010 follow-up survey (see Annex C for the questionnaire).

- New questions about whether the patient had enough information to make their choice, choice of date and time and awareness of how to complain were added.
- Patients offered choice were asked to select the single most important source of information, instead of all that apply, since this gives a more powerful indication of which were most important.
- Patients offered choice were asked to select the single most important factor when they chose their hospital, instead of all patients being invited to select factors that would be important to them, since this gives a more powerful indication of which were most applicable.
- New questions about long-standing illness and the first part of the patient postcode were added, to improve analysis of the extent to which PCT results are affected by underlying health or socio-economic inequalities.

Owing to a lack of redesigned questionnaires in a few providers, some patients were sent copies of the previous survey questionnaire. 1,776 responses were received to the previous questionnaire, 3% of the total (equivalent to 1,886 weighted responses, see below). These were included in the analysis of all questions common to both questionnaires, but omitted from analysis of the new or revised questions.

Response A total 69,075 patients responded to the survey, a response rate of 34%. Of these, 35 responses did not clearly indicate the code of the issuing Trust or IS provider (despite pre-printing of the organisation code) and were omitted as invalid. In addition, 1,010 (1.5%) responses did not indicate the responsible PCT, fewer than in previous surveys as it was often possible to impute the PCT code from the postcode district entered by the patient. Such cases were included in national analysis since they had a valid provider code. This resulted in an effective national response rate of 34% (69,040 valid responses). This compares with valid response rates of between 25% and 33% in surveys to January 2008 (except 40% in September 2007), 50% in March 2008 and between 35% and 38% in May 2008 to March 2009.

Although the survey results were weighted for age and sex bias among respondents (see below), they may be subject to other response bias for which no adjustment can be made.

Weighting for non-response The age and sex of respondents to the survey was compared with Hospital Episodes Statistics (HES) Outpatients data sourced from the Information Centre for Health and Social Care (IC)(^1). The HES data related to 9.8 million first attendance

(^1) For details of the IC (HES) Outpatients data, see www.hesonline.org.uk. outpatient appointments in 2008-09(^1) for patients with known sex and age 16 and over where the source of referral was a General Medical Practitioner and the specialty was not one of those excluded from choice (cancer, obstetrics and mental health). There was a lower proportion of younger patients among the survey respondents than in the overall HES distribution, for both males and females, see Figure B.1.

**Figure B.1 Percentage of survey respondents by age and sex, compared with the expected distribution**

![Bar chart showing observed and expected sample distributions by age and sex.](image)

Although many of the survey results differed only slightly by age and sex, this sample difference is sufficiently marked that the decision was made to weight the national data to adjust for this response bias. No weighting was done by ethnic group since the HES outpatient data did not have an ethnic group recorded. The national weighting was not applied to PCT or SHA results because the age and sex distribution differs by PCT and the HES outpatient data may not provide a sufficiently robust comparison.

**Issues for PCT results**

Survey forms were marked with the commissioning organisation (Care Trust or Primary Care Trust, PCT) prior to issue. In some cases, PCT codes were invalid or illegible and these were imputed where possible using the PCT entry, Provider code or first part of the patient postcode. SHA results were aggregated from the PCT data, which were not weighted for any age, sex or ethnicity bias among respondents.

The number of valid responses received varied by PCT, from fewer than 60 patients in 20 PCTs to more than 1,000 in 16 PCTs, as shown in Annex Table A.8. For seven PCTs where there were significant local problems with the survey process,

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(^1) Provisional monthly HES data, available for most months of 2009-10, shows a similar distribution to the final 2008-09 results but may be less robust for weighting purposes. only between 2 and 19 responses were received (see Annex Table A.8). Results for these PCTs are likely to be misleading and so were omitted from the PCT analysis. If responses were unbiased for the other 145 PCTs, the average confidence interval(^1) around the percentage of patients offered choice in each PCT would be ± 6%, but in some cases this is as low as ± 2% or, in the worst case, as high as ± 20%. The variable response, possibility of response bias and lack of weighting for age and sex bias at a local level means that PCT results should be treated with some caution. This is particularly the case for PCTs where fewer than 100 patients have responded to the survey.

(^1) The 95% confidence interval for a PCT indicates the range in which the percentage of patients responding ‘Yes’ to the question is 95% likely to fall, given sampling error (but assuming no response bias). It is calculated by approximation to a Binomial distribution. Annex C: Survey questionnaire

Q1. Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment? PLEASE TICK ONE BOX ONLY Yes ........................................... □ No ........................................... □

Q2. Did you discuss which hospital you might go to with your GP? PLEASE TICK ONE BOX ONLY Yes ........................................... □ No ........................................... □ Don’t know .................................. □

Q3. Were you offered a choice of hospital for your first hospital appointment? PLEASE TICK ONE BOX ONLY Yes ........................................... □ No ........................................... □ Don’t know .................................. □

Please only answer Q4, Q5 and Q6 if you answered yes at Q3

Q4. Which was the single most important source of information for you when you chose your hospital? PLEASE TICK ONE BOX ONLY My GP ........................................... □ A booklet or leaflet about the choices I have ........................................... □ NHS Choices Website ........................................... □ Other internet site ........................................... □ Friends/family members/own experience ........................................... □ Someone else at my GP surgery ........................................... □ Local patient organisation ........................................... □ Staff at Clinical Assessment or Referral Centre ........................................... □ Don’t know ........................................... □

Q5. Did you have enough information to help you make your choice? PLEASE TICK ONE BOX ONLY Yes ........................................... □ No ........................................... □

Q6. Which was the single most important thing for you when you chose your hospital? PLEASE TICK ONE BOX ONLY Availability of car parking ........................................... □ Cost of car parking ........................................... □ Close to your home or work ........................................... □ Accessible on public transport/Travel costs ........................................... □ Cleanliness/rates of infection ........................................... □ Friendliness of staff ........................................... □ Quality of care ........................................... □ Personal experience of the hospital ........................................... □ Experience of friends or family members ........................................... □ GP/assessment centre doctor recommendation ........................................... □ Reputation of hospital ........................................... □ Ability to see consultant of your choice ........................................... □ Good previous experience ........................................... □ Convenience of appointment time ........................................... □ Length of wait for appointment ........................................... □ Quality of food ........................................... □ Standard of facilities ........................................... □ Don’t know ........................................... □

Everyone should answer the remaining questions

Q7. Were you able to go to the hospital that you wanted to go to? PLEASE TICK ONE BOX ONLY Yes ........................................... □ No ........................................... □ I didn’t have a preference ........................................... □ Q8. How did you book your first hospital appointment? PLEASE TICK ONE BOX ONLY By telephone via the appointments line 0845 608 8888 ........................................... □ On screen (done by GP) ........................................... □ On screen (done by GP practice staff) ........................................... □ On the internet via myHealthSpace ........................................... □ On the internet via NHS Choices ........................................... □ The GP wrote to the hospital asking them to contact me ........................................... □ Via a local call centre ........................................... □ Other ........................................... □ Don’t know ........................................... □ I have not booked an appointment yet ........................................... □

Q9. When your first hospital appointment was made, were you offered a choice of different dates and times of day? PLEASE TICK ONE BOX ONLY Yes ........................................... □ No ........................................... □ Don’t know ........................................... □

Q10. How satisfied or dissatisfied were you with how long you had to wait from the time your GP referred you to a hospital to when you actually saw the hospital specialist? PLEASE TICK ONE BOX ONLY Very satisfied ........................................... □ Fairly satisfied ........................................... □ Not very satisfied ........................................... □ Not at all satisfied ........................................... □ Don’t know ........................................... □ I do not have an appointment date ........................................... □

Q11. Are you aware of how to complain if you feel you were not offered a choice of hospital? PLEASE TICK ONE BOX ONLY Yes ........................................... □ No ........................................... □ Don’t know ........................................... □

Q12. Are you male or female? PLEASE TICK ONE BOX ONLY Male ........................................... □ Female ........................................... □

Q13. How old are you? PLEASE TICK ONE BOX ONLY 16-34 ........................................... □ 35-54 ........................................... □ 55-64 ........................................... □ 65 or over ........................................... □

Q14. To which of these ethnic groups would you say you belong? PLEASE TICK ONE BOX ONLY White British ........................................... □ Irish ........................................... □ Any other white background ........................................... □ Mixed White and Black Caribbean ........................................... □ White and Black African ........................................... □ White and Asian ........................................... □ Any other mixed background ........................................... □ Asian or Asian British Indian ........................................... □ Pakistani ........................................... □ Bangladeshi ........................................... □ Any other Asian background ........................................... □ Black or Black British Caribbean ........................................... □ African ........................................... □ Any other Black background ........................................... □ Chinese or other ethnic group Chinese ........................................... □ Any other ethnic group ........................................... □

Q15. Do you have any long-standing illness, disability or infirmity? By long standing I mean anything that has troubled you over a period of time or that is likely to affect you over a period of time. PLEASE TICK ONE BOX ONLY Yes – I have a long standing illness ........................................... □ Yes – I have a disability ........................................... □ No ........................................... □ Prefer not to say ........................................... □

Q16. Please write the first part of your postcode below, e.g. SE15 or ME5.

□ □ □ □ Annex D: Combined survey results by age, sex, ethnic group and long-standing illness

Background Results of the survey by the age, sex and ethnic group of respondents were last presented in the report for referrals made in December 2008(^1). That report compiled results for the first sixteen surveys. These were aggregated for comparison, since the differences observed by age, sex and ethnic group were generally consistent over all the surveys and otherwise small samples for some groups made comparisons inconclusive. This annex updates that analysis by presenting the analysis of the seventeenth and eighteenth surveys against the combined results of the first sixteen surveys(^2). In addition, results of the latest survey are presented by whether or not the patient had a long-standing illness or disability.

Age and sex results The proportion of patients recalling being offered a choice of hospital for their first outpatient appointment was over 2% higher for women than for men in February 2010, a similar difference to that seen in previous surveys. The proportion also varied by age (see Figure D.1 and Table D.2), with the highest proportion of patients offered choice being for 35-54 year olds and 55 to 64 year olds whilst there were lower proportions for 16-34 year olds and those aged over 65.

Figure D.1 Percentage of patients offered choice by age and sex, combined survey results

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(^1) Report on the National Patient Choice Survey – December 2008 England, DH, May 2009

(^2) Surveys 1 to 4 are for referrals made in May/June, July, September and November 2006. Surveys 5 to 8 are for referrals made in January, March, May and July 2007. Surveys 9 to 12 are for referrals made in September and November 2007 and January and March 2008. Surveys 13 to 16 are for referrals made in May, July, September and December 2008. The proportion of patients aware before visiting their GP that they had a choice of hospital for their first outpatient appointment increased with age, see Figure D.2 and Table D.1. This trend was maintained across all the surveys to date, despite the general increase in awareness. Women generally had a greater awareness of choice, except in the over 65 age band where men had a greater awareness.

Figure D.2 Percentage of patients aware of choice by age and sex, combined survey results

The proportion of patients who were able to go to the hospital they wanted increased with age, whilst the proportion who had no preference decreased with age, see Figure D.3 and Table D.3(^1). Men were somewhat less inclined to have a preference than women, slightly more of whom said they went to their hospital of choice.

Figure D.3 Percentage of patients going where they wanted or having no preference, by age and sex

(^1) This question was introduced from the 10(^{th}) survey (November 2007). Ethnic group results

The proportion of patients recalling being offered a choice of hospital for their first outpatient appointment was higher for patients in the White ethnic group than for Black and Minority Ethnic group (BME) patients(^1), see Figure D.4 and Table D.2. This difference reduced over the series of surveys but was relatively consistent over the latest surveys, with more variation for uncombined survey results due to smaller numbers. The Asian or Asian British ethnic group was up to 12% below the overall proportion of patients offered choice in the latest surveys, as was the Other group(^2) (see Table D.2). The Black or Black British group and those of Mixed ethnicity were slightly closer to average. The Chinese group showed most variability and was not always below average (but based on less than 0.4% of responses and omitted from Figure D.4).

The proportion of patients aware before visiting their GP that they had a choice of hospital for their first outpatient appointment was higher for patients in the White ethnic group than for Black and Minority Ethnic group (BME) patients, see Figure D.5 and Table D.1. Of all BME patients, those considering themselves in the Mixed and Asian or Asian British groups had the highest awareness of choice. Nevertheless, awareness continued to rise over time across all groups.

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(^1) The results are weighted to adjust for age and sex bias amongst respondents to the surveys, but not to adjust for the differences in the distribution of patients by age and sex between ethnic groups. In particular, the most common age group for BME respondents in February 2010 was 35-54 years old, compared to 65 or over in the White group. In addition, no adjustment has been made for other factors that might affect the comparison by ethnic group, such as any correlation between the proportion of patients in different ethnic groups and geographic or deprivation effects. Separate study indicates that if we control for these effects, the main results are broadly consistent with those presented here.

(^2) Patients in all ethnic groups with ‘other’ in the description were invited to write their ethnicity in a box, in surveys from November 2007 to March 2009. In the February 2010 survey, a box was only provided for ‘Any other ethnic group’ and this may be why more patients selected this option. The proportion of patients who were able to go to the hospital they wanted was higher for patients in the White ethnic group than for Black and Minority Ethnic group (BME) patients, see Figure D.6 and Table D.3. All BME groups were less likely to have a preference of hospital than White patients (even when offered a choice).

Figure D.6 Percentage of patients going to the hospital they wanted or having no preference relative to the average, by main ethnic group

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1 This question was introduced from the 10th survey (November 2007). Long-standing illness results

The proportion of patients aware before visiting their GP that they had a choice of hospital for their first outpatient appointment was higher for patients with a long-standing illness or disability(^1) (57%) than for those without (51%), see Figure D.7 and Table D.1. However, most of this difference is explained by the proportion of patients with a long-standing illness or disability rising with age, since awareness increases with age, so these factors may be related. The proportion of patients recalling being offered choice varied less by whether or not the patient had an illness or disability (see Table D.2), as did the proportion going to the hospital they wanted (see Table D.3).

Figure D.7 Percentage of patients aware of choice and offered choice, by whether patient had a long-standing illness or disability, February 2010

(^1) For the first time in the series of National Patient Choice Surveys, patients were asked whether they had a long-standing illness or disability, defined as “anything that has troubled you over a period of time or that is likely to affect you over a period of time”. 1,847 (3%) responses had both a long-standing illness and a disability.

### Table D.1 Percentage of patients aware of choice by age, sex, ethnic group and long-standing illness, surveys to date

| | Surveys 1 to 4 2006¹ | Surveys 5 to 8 2007¹ | Surveys 9 to 12 2007-08¹ | Surveys 13 to 16 2008¹ | Survey 17 March 2009 | Survey 18 February 2010 | |--------------------------|----------------------|----------------------|--------------------------|------------------------|----------------------|------------------------| | | Total² %Yes³ | Total² %Yes³ | Total² %Yes³ | Total² %Yes³ | Total² %Yes³ | Total² %Yes³ | | **Total** | 276,369 32% | 285,736 37% | 351,834 42% | 352,316 47% | 93,217 50% | 69,040 54% | | **By age and sex:** | | | | | | | | Male 16-34 | 18,601 23% | 19,237 27% | 22,851 31% | 20,237 36% | 5,705 36% | 4,251 39% | | 35-54 | 31,699 26% | 32,784 31% | 40,461 34% | 39,431 39% | 10,436 42% | 7,814 45% | | 55-64 | 19,124 34% | 19,779 38% | 24,479 43% | 24,004 50% | 6,680 52% | 4,967 55% | | 65+ | 35,105 40% | 36,306 45% | 44,885 50% | 43,896 56% | 12,443 60% | 9,302 62% | | Total¹ | 107,761 32% | 111,677 37% | 134,298 41% | 128,169 46% | 35,395 49% | 26,462 52% | | Female 16-34 | 36,415 25% | 37,661 29% | 50,405 34% | 57,961 38% | 13,831 40% | 10,346 43% | | 35-54 | 51,572 32% | 53,647 36% | 68,115 41% | 70,646 47% | 17,937 50% | 13,452 55% | | 55-64 | 24,102 35% | 24,927 41% | 30,932 47% | 30,519 54% | 8,278 57% | 6,121 61% | | 65+ | 45,060 37% | 46,602 43% | 57,584 48% | 56,242 55% | 15,461 58% | 11,500 61% | | Total¹ | 160,152 32% | 165,791 37% | 208,456 42% | 216,041 48% | 55,679 51% | 41,661 55% | | **By ethnic group:** | | | | | | | | White | 244,948 33% | 251,765 38% | 312,955 42% | 311,425 48% | 82,694 51% | 61,985 55% | | All BME | 24,138 26% | 26,237 30% | 30,925 34% | 33,661 39% | 8,458 41% | 5,738 44% | | Mixed | 3,430 28% | 3,605 31% | 7,648 36% | 10,373 42% | 2,697 45% | 964 47% | | Asian or Asian British | 10,655 26% | 12,049 32% | 12,489 35% | 12,555 39% | 3,044 41% | 2,315 45% | | Black or Black British | 5,986 25% | 6,236 27% | 7,297 32% | 7,732 35% | 1,966 40% | 1,536 41% | | Chinese | 1,192 26% | 1,309 30% | 1,340 31% | 1,323 36% | 301 31% | 219 34% | | Other | 2,874 29% | 3,038 31% | 2,151 31% | 1,678 37% | 450 37% | 705 48% | | \*\*By long-standing illness:\*\*⁵ | | | | | | | | Long-standing illness | | | | | 22,689 57% | | | Disability | | | | | 9,262 57% | | | Neither | | | | | 31,627 51% | |

1. Surveys 1 to 4 are for referrals made in May/June, July, September and November 2006; surveys 5 to 8 are for referrals made in January, March, May and July 2007; surveys 9 to 12 are for referrals made in September and November 2007 and January and March 2008 and surveys 13 to 16 are for referrals made in May, July, September and December 2008. For a breakdown by survey for surveys 1 to 16, see previous reports.
2. Total valid responses. All figures are weighted, ie adjusted for national age and sex bias in the responding sample.
3. Percentage of patients who said Yes to Q1 ‘Before you visited your GP, did you know that you now have a choice of hospitals that you can go to for your first hospital appointment?’
4. Male and Female totals include those of unknown age. Overall totals also include those of unknown sex or ethnic group.
5. The question on long-standing illness was introduced this survey, defined as “anything that has troubled you over a period of time or that is likely to affect you over a period of time”. 1,847 (3%) responses had both a long-standing illness and a disability.

### Table D.2 Percentage of patients offered choice by age, sex, ethnic group and long-standing illness, surveys to date

| Numbers and percentages | Surveys 1 to 4 2006¹ | Surveys 5 to 8 2007¹ | Surveys 9 to 12 2007-08¹ | Surveys 13 to 16 2008¹ | Survey 17 March 2009 | Survey 18 February 2010 | |-------------------------|----------------------|----------------------|--------------------------|------------------------|----------------------|------------------------| | Total | 276,369 | 285,736 | 351,834 | 352,316 | 93,217 | 69,040 | | By age and sex: | | | | | | | | Male 16-34 | 18,601 | 19,237 | 22,851 | 20,237 | 5,705 | 4,251 | | 35-54 | 31,699 | 32,784 | 40,461 | 39,431 | 10,436 | 7,814 | | 55-64 | 19,124 | 19,779 | 24,479 | 24,004 | 6,680 | 4,967 | | 65+ | 35,105 | 36,306 | 44,885 | 43,896 | 12,443 | 9,302 | | Total | 107,761 | 111,677 | 134,298 | 128,169 | 35,395 | 26,462 | | Female 16-34 | 36,415 | 37,661 | 50,405 | 57,961 | 13,831 | 10,346 | | 35-54 | 51,872 | 53,647 | 68,115 | 70,646 | 17,937 | 13,452 | | 55-64 | 24,102 | 24,927 | 30,932 | 30,519 | 8,278 | 6,121 | | 65+ | 45,060 | 46,602 | 57,584 | 56,242 | 15,461 | 11,500 | | Total | 160,152 | 165,791 | 208,456 | 216,041 | 55,679 | 41,661 | | By ethnic group: | | | | | | | | White | 244,948 | 251,765 | 312,955 | 311,425 | 82,694 | 61,985 | | All BME | 24,138 | 26,237 | 30,925 | 33,661 | 8,458 | 5,738 | | Mixed | 3,430 | 3,605 | 7,648 | 10,373 | 2,697 | 964 | | Asian or Asian British | 10,655 | 12,049 | 12,489 | 12,555 | 3,044 | 2,315 | | Black or Black British | 5,986 | 6,236 | 7,297 | 7,732 | 1,966 | 1,536 | | Chinese | 1,192 | 1,309 | 1,340 | 1,323 | 301 | 219 | | Other | 2,874 | 3,038 | 2,151 | 1,678 | 450 | 705 | | By long-standing illness:⁵ | | | | | | | | Long-standing illness | | | | | 22,689 | 47% | | Disability | | | | | 9,262 | 46% | | Neither | | | | | 31,627 | 50% |

1. Surveys 1 to 4 are for referrals made in May/June, July, September and November 2006; surveys 5 to 8 are for referrals made in January, March, May and July 2007; surveys 9 to 12 are for referrals made in September and November 2007 and January and March 2008 and surveys 13 to 16 are for referrals made in May, July, September and December 2008. For a breakdown by survey for surveys 1 to 16, see previous reports.
2. Total valid responses. All figures are weighted, ie adjusted for national age and sex bias in the responding sample.
3. Percentage of patients who said Yes to the question: ‘Were you offered a choice of hospital for your first hospital appointment?’
4. Male and Female totals include those of unknown age. Overall totals also include those of unknown sex or ethnic group.
5. The question on long-standing illness was introduced this survey, defined as “anything that has troubled you over a period of time or that is likely to affect you over a period of time”. 1,847 (3%) responses had both a long-standing illness and a disability. Table D.3 Percentage of patients able to go where they wanted by age, sex, ethnic group and long-standing illness, surveys to date

| By age and sex: | Surveys 10 to 12 2007-08 | Surveys 13 to 16 2008 | Survey 17 March 2009 | Survey 18 February 2010 | |----------------|--------------------------|-----------------------|----------------------|------------------------| | Total | 259,289 | 352,316 | 93,217 | 69,040 | | %Yes | 66% | 67% | 67% | 67% | | %No | 24% | 23% | 23% | 22% | | By age and sex:| | | | | | Male 16-34 | 16,632 | 20,237 | 5,705 | 4,251 | | %Yes | 61% | 62% | 64% | 61% | | %No | 30% | 28% | 26% | 27% | | 35-54 | 29,861 | 39,431 | 10,436 | 7,814 | | %Yes | 63% | 63% | 63% | 63% | | %No | 27% | 27% | 26% | 25% | | 55-64 | 18,084 | 24,004 | 6,680 | 4,967 | | %Yes | 67% | 67% | 67% | 69% | | %No | 23% | 23% | 23% | 22% | | 65+ | 33,147 | 43,896 | 12,443 | 9,302 | | %Yes | 98,165 | 128,169 | 35,395 | 26,462 | | %No | 66% | 66% | 67% | 66% | | Female 16-34 | 38,228 | 57,961 | 13,831 | 10,346 | | %Yes | 63% | 63% | 63% | 64% | | %No | 28% | 28% | 28% | 27% | | 35-54 | 50,771 | 70,646 | 17,937 | 13,452 | | %Yes | 67% | 67% | 67% | 67% | | %No | 23% | 23% | 23% | 22% | | 55-64 | 22,873 | 30,519 | 8,278 | 6,121 | | %Yes | 69% | 69% | 69% | 69% | | %No | 21% | 20% | 20% | 19% | | 65+ | 42,517 | 56,242 | 15,461 | 11,500 | | %Yes | 154,877 | 216,041 | 55,679 | 41,661 | | %No | 67% | 67% | 67% | 68% | | By ethnic group:| | | | | | White | 231,024 | 311,425 | 82,694 | 61,985 | | %Yes | 67% | 68% | 68% | 68% | | %No | 23% | 23% | 23% | 22% | | All BME | 22,825 | 33,661 | 8,458 | 5,738 | | %Yes | 60% | 61% | 62% | 62% | | %No | 27% | 26% | 26% | 26% | | Mixed | 6,605 | 10,373 | 2,697 | 1,536 | | %Yes | 62% | 63% | 64% | 59% | | %No | 26% | 25% | 24% | 28% | | Asian or Asian British | 8,834 | 12,555 | 3,044 | 2,315 | | %Yes | 60% | 62% | 61% | 63% | | %No | 28% | 26% | 27% | 25% | | Black or Black British | 5,308 | 7,732 | 1,966 | 1,536 | | %Yes | 59% | 59% | 59% | 59% | | %No | 28% | 29% | 29% | 28% | | Chinese | 834 | 1,323 | 301 | 219 | | %Yes | 62% | 63% | 64% | 64% | | %No | 29% | 28% | 28% | 25% | | Other | 1,244 | 1,678 | 450 | 705 | | %Yes | 58% | 60% | 62% | 60% | | %No | 28% | 26% | 24% | 26% |

1. The question was introduced from Survey 10 (November 2007). For a breakdown by survey for surveys 10 to 16, see previous reports.
2. Total valid responses. All figures are weighted, ie adjusted for national age and sex bias in the responding sample.
3. Percentage of patients who said Yes or that they had No preference respectively to the question 'Were you able to go to the hospital that you wanted to go to?'
4. Male and Female totals include those of unknown age. Overall totals also include those of unknown sex or ethnic group.
5. The question on long-standing illness was introduced this survey, defined as "anything that has troubled you over a period of time or that is likely to affect you over a period of time". 1,847 (3%) responses had both a long-standing illness and a disability.